Zhonghua Nei Ke Za Zhi
· 2025 Oct · PMID 41083391
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To assess the attitudes toward and factors influencing starting insulin use among community-based patients with type 2 diabetes (T2D). A cross- sectional study. This secondary analysis used baseline data from patients w...To assess the attitudes toward and factors influencing starting insulin use among community-based patients with type 2 diabetes (T2D). A cross- sectional study. This secondary analysis used baseline data from patients with T2D recruited through convenience sampling from a community-based peer support intervention study implemented in nine community health service centers in Shanghai since 2017. Attitudes toward insulin use were assessed using the Chinese Attitudes to Starting Insulin Questionnaire (Ch-ASIQ); the higher the score, the more negative the attitude toward starting insulin use. Multiple linear regression was used to analyze the factors influencing attitudes toward starting insulin use. A total of 336 patients with T2D were included in the survey. The patients had a mean age of (67.7±7.9) years, mean disease duration of (13.62±7.73) years, relatively low levels of depression [Patient Health Questionnaire 8 (PHQ-8): 2 (0, 5)] and diabetes distress [Diabetes Distress Scale 4 (DDS-4): 1.97±0.95], and suboptimal target achieving rates of risk factors including body mass index, blood pressure, blood glucose, and lipid levels. The total score on the Ch-ASIQ among all patients was 1.84±0.55. Multivariate analyses showed that refusing insulin use was positively significantly associated with higher scores on the Ch-ASIQ and the three sub-dimensions of "Factors promoting self-efficacy," "Fear of pain or needles," and "Time and family support" [ (95%): 0.515 (0.355-0.674), 0.728 (0.470-0.986), 0.273 (0.030-0.515), 0.909 (0.606-1.213), all <0.05]. In addition, disease duration [ (95%):-0.011 (-0.019 to -0.004)] was independently negatively associated with the Ch-ASIQ score. In comparison, age [ (95%): 0.011 (0.003-0.018)], DDS-4 [0.129 (0.069-0.190)], and PHQ-8 [0.015 (0.000-0.029)] were independently positively associated with the Ch-ASIQ score (all <0.05). There were slight differences in the factors influencing the four sub-dimensions of the Ch-ASIQ scale. Community-based patients with T2D had moderate negative attitudes toward starting insulin treatment. Refusing insulin use, shorter diabetes duration, older age, higher diabetes distress, and higher levels of depression were associated with higher negative attitudes towards starting insulin use.
Guo LJ, Li CJ, Wei H
… +5 more, Ding Y, Zhao Y, Piao YS, Guo Y, Gao YN
Zhonghua Nei Ke Za Zhi
· 2025 Oct · PMID 41083390
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To improve the understanding of the clinical manifestation of immunoglobulin G-related disease (IgG-RD) with neurological involvement. Patients presenting with neurological symptoms and biopsy-confirmed IgG-RD were enro...To improve the understanding of the clinical manifestation of immunoglobulin G-related disease (IgG-RD) with neurological involvement. Patients presenting with neurological symptoms and biopsy-confirmed IgG-RD were enrolled between March 2014 and March 2024 from the Department of Neurology of Xuanwu Hospital of Capital Medical University. Medical record data of all patients were retrospectively reviewed, including clinical manifestations, laboratory findings, radiological results, pathology, treatments, and outcomes. RD were enrolled between March Nine patients (five males, four females; median age at onset: 63 years) were included in the study. Neurological manifestations consisted of pachymeningitis in six cases, peripheral nerve involvement in two, and brain parenchyma involvement in one. Four patients displayed isolated neurologic symptoms. The most common clinical manifestations were headache and cranial nerve palsy, each involving five cases. Magnetic resonance imaging showed thickening and enhancement of the dura mater in the six patients with pachymeningitis. Four of these cases involved the posterior cranial fossa, 3 presented with an inflammatory pseudotumor, and 2 involved the spinal cord. Four patients with pachymeningitis had normal serum IgG concentrations. Eight patients exhibited elevated serum C-reactive protein or erythrocyte sedimentation rates, with some also showing decreased complement C3 and C4 levels. Cerebrospinal fluid immunoglobulin was elevated in all nine cases. In all cases, histopathologic biopsy results showed extensive infiltration of lymphocytes and plasma cells, with the latter displaying IgGabnormalities. All patients received glucocorticoid therapy, with six also receiving immunosuppressants. All patients were followed up for a median of 30 months, with outcomes including two complete remissions, five partial remissions, one unchanged condition, and one death. Six patients experienced a relapse. Isolated hypertrophic pachymeningitis is the most common manifestation of IgG-RD, often occurring in the absence of elevated serum IgG levels. Peripheral nerve and brain parenchyma involvement can also be seen. Clinical manifestations are non-specific, and histopathologic biopsy is frequently required for diagnosis. Although the disease responds well to hormone treatment, recurrence is common. Early combined immunosuppressive therapy can improve prognosis.
Li CB, Chen P, Zhou SP
… +7 more, Kang HH, Wen XW, Yi SC, Bai X, Wang Y, Zhang L, Wang HY
Zhonghua Nei Ke Za Zhi
· 2025 Oct · PMID 41083389
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To evaluate the diagnostic value of native T1 mapping in differentiating Oxford classification (MEST-C) scores in patients with IgA nephropathy. In this prospective study, patients who underwent both T1 mapping and rena...To evaluate the diagnostic value of native T1 mapping in differentiating Oxford classification (MEST-C) scores in patients with IgA nephropathy. In this prospective study, patients who underwent both T1 mapping and renal biopsy at the First Medical Center of the Chinese PLA General Hospital between April 2023 and October 2024 were consecutively enrolled. Two radiologists, blinded to clinical and pathological information, measured renal T1 mapping parameters, including cortical T1 (cT1), medullary T1 (mT1), the corticomedullary difference (ΔT1), and the corticomedullary ratio (T1 ratio). Clinical and renal biopsy data based on the Oxford classification from patients with IgA nephropathy were collected. The Oxford classification includes five indicators: Mesangial hypercellularity (M), Endocapillary hypercellularity (E), Segmental glomerulosclerosis or adhesion (S), Tubular atrophy/interstitial fibrosis (T), and Cellular or fibrocellular crescents (C). Spearman correlation analysis was applied to evaluate the associations between MEST-C scores and T1 parameters. The diagnostic performance of T1 parameters for discriminating among scores of the Oxford classification was analyzed using the receiver operating characteristic (ROC) curve. A total of 124 patients with IgA nephropathy were included in this study [66 males, 58 females; age 19-70 years, 39 (30, 51) years]. Except for the E indicator, M, S, T, and C were significantly correlated with renal T1 values (0.177-0.414, all <0.05). cT1 showed the best diagnostic efficacy for the S score, with an area under the curve (AUC) of 0.798, a sensitivity of 68.7%, and a specificity of 88.0%. The best T1 parameter for differentiating the T score was the T1 ratio, with an AUC of 0.687, a sensitivity of 57.9%, and a specificity of 79.1%. Native T1 mapping can be used for the non-invasive assessment of the S and T scores in the Oxford classification of patients with IgA nephropathy.
Wang CF, Pan B, Xie XS
… +3 more, Xu CP, Chen JH, Zhang P
Zhonghua Nei Ke Za Zhi
· 2025 Oct · PMID 41083388
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To investigate the effect of pre-dialysis blood pressure (Pre-BP) on all-cause and cardiovascular disease (CVD) mortality in patients on maintenance hemodialysis (MHD). This single-center, retrospective cohort study enr...To investigate the effect of pre-dialysis blood pressure (Pre-BP) on all-cause and cardiovascular disease (CVD) mortality in patients on maintenance hemodialysis (MHD). This single-center, retrospective cohort study enrolled patients undergoing first-time hemodialysis between January 1, 2007, and June 30, 2021, from the dialysis registry of the First Affiliated Hospital, Zhejiang University School of Medicine. General information and laboratory parameters were collected. Pre-dialysis systolic blood pressure (Pre-SBP) and pre-dialysis diastolic blood pressure (Pre-DBP) were calculated and averaged at 4-6 months after dialysis. The mean Pre-SBP and Pre-DBP values were used as continuous variables, and restricted cubic spline (RCS) curves were used to assess the relationship between Pre-BP and mortality risk. Patients were subsequently divided into six groups for Pre-DBP and six groups for Pre-SBP combined with Pre-DBP. Survival analyses were performed using the Kaplan-Meier method. All-cause and CVD mortality were compared between groups using the log-rank test. Multivariate Cox regression models were used to analyze the associations between Pre-BP and all-cause and CVD mortality. A total of 1 213 patients were enrolled. By the end of follow-up, 175 patients (14.4%) had died, of whom 62 (35.4%) died from CVD. Kaplan-Meier survival curves showed that the Pre-DBP<65 mmHg group (1 mmHg=0.133 kPa) had a significantly lower cumulative survival rate (²=90.52, <0.001) and a significantly higher CVD mortality rate (²=35.54, <0.001) than the other groups. The combined Pre-SBP and Pre-DBP analysis showed that the Pre-SBP≥150 mmHg and Pre-DBP<80 mmHg groups had a significantly lower cumulative survival rate (²=45.58, <0.001) and a significantly higher CVD mortality rate (²=30.13, <0.001) than the other groups. Multivariate Cox regression model analysis showed that compared with other groups, the risk of MHD all-cause mortality was increased in the Pre-DBP<65 mmHg group and the Pre-SBP≥150 mmHg and Pre-DBP<80 mmHg group [ (95%)=1.927 (1.195-3.109), 3.298 (1.567-6.939), both <0.05]. In patients undergoing MHD, Pre-DBP<65 mmHg or Pre-SBP≥150 mmHg and Pre-DBP<80 mmHg were independent risk factors for all-cause mortality, with a low cumulative survival rate and a high risk of CVD mortality.
Scientific Committee of the China IgA Nephropathy Network (IIgANN-China), Chinese Preventive Medicine Association′s Committee for the Prevention and Control of Kidney Diseases
Zhonghua Nei Ke Za Zhi
· 2025 Oct · PMID 41083387
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IgA nephropathy (IgAN) is the most common primary glomerular disease in China and a leading cause of end-stage renal disease (uremia) in young adults. The diagnosis, prognostic assessment, and treatment strategies for Ig...IgA nephropathy (IgAN) is the most common primary glomerular disease in China and a leading cause of end-stage renal disease (uremia) in young adults. The diagnosis, prognostic assessment, and treatment strategies for IgAN and IgA vasculitis with nephritis (IgAVN) have been comprehensively evaluated by the Scientific Committee of the China IgA Nephropathy Network (IIgANN-China) and the Chinese Preventive Medicine Association's Committee for the Prevention and Control of Kidney Diseases based on recent literature and evidence-based medicine. As a result, clinical practice guidelines specifically tailored to Chinese patients have been developed. These guidelines introduce an integrated therapeutic framework that incorporates risk-stratified treatment, targeting both immune-mediated renal injury and chronic kidney disease progression, as well as stage-specific treatment, including both the induction and maintenance phases. The aim is to provide standardized guidance and practical recommendations for the clinical management of IgAN and IgAVN in China.
Zhonghua Nei Ke Za Zhi
· 2025 Sep · PMID 40904303
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This report describes the case of a 43-year-old male presenting with severe anemia (hemoglobin, HGB 35 g/L). A comprehensive evaluation encompassing bone marrow morphology (24% ring sideroblasts), genetic testing (SF3B1-...This report describes the case of a 43-year-old male presenting with severe anemia (hemoglobin, HGB 35 g/L). A comprehensive evaluation encompassing bone marrow morphology (24% ring sideroblasts), genetic testing (SF3B1-negative), iron metabolism studies (ferritin 1 179 μg/L), and imaging (liver MRI T2* value 1.1 ms) was performed for diagnosis, treatment planning, and assessment of outcomes. Initially diagnosed as having myelodysplastic syndrome with ring sideroblasts (MDS-RS), the patient experienced relapse after 10 months of luspatercept treatment. Following the identification of a significant retrospective history of heavy alcohol consumption (250 g/day for 20 years), vitamin B therapy resulted in a rapid increase in HGB to 85 g/L within 10 days, reaching 134 g/L after one month, confirming a diagnosis of alcohol-induced sideroblastic anemia (SA). This case highlights that in SA lacking clonal evidence, the exclusion of reversible causes such as alcoholism should be prioritized. While luspatercept demonstrated short-term efficacy in this patient with non-clonal SA, caution is warranted regarding potential masking of the underlying etiology. Concurrent monitoring of iron overload and early initiation of iron chelation therapy are crucial in alcoholic SA to prevent hepatic damage.
Zhonghua Nei Ke Za Zhi
· 2025 Sep · PMID 40904296
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A retrospective analysis was conducted on 26 patients with relapsed and refractory multiple myeloma (RRMM) who were treated with carfilzomib-based regimens at Beijing Chaoyang Integrative Medicine Rescue and First Aid Ho...A retrospective analysis was conducted on 26 patients with relapsed and refractory multiple myeloma (RRMM) who were treated with carfilzomib-based regimens at Beijing Chaoyang Integrative Medicine Rescue and First Aid Hospital from July 2021 to May 2024. The median number of treatment cycles was 5 (range, 2-8). The overall response rate was 53.8% (14/26). The median follow-up duration was 9.5 months, and the median progression-free survival (PFS) was 8.6 months (range, 1.7-25.2 months). Patients without plasmacytoma recurrence (=17) had a PFS of 12.3 months. In contrast, patients with plasmacytoma recurrence (=9) had a PFS of 6.2 months. The difference in PFS between these two groups was statistically significant (=0.013). Age (over 65 vs. 65 or younger), and treatment line (more than three vs. three or fewer) did not significantly affect treatment efficacy (all >0.05). Common adverse reactions of grade 3 or higher included hematologic adverse reactions in 10 cases, which improved with symptomatic treatment. Non-hematologic adverse reactions included pulmonary infection (2 cases), renal failure (1 case), and heart failure (1 case). In conclusion, carfilzomib-based regimens demonstrate good clinical efficacy and manageable safety in the treatment of RRMM.
Yin YQ, Li LQ, Cheng Y
… +4 more, Zang L, Gu WJ, Lyu ZH, Mu YM
Zhonghua Nei Ke Za Zhi
· 2025 Sep · PMID 40904295
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Clinical data of two patients with X-linked adrenoleukodystrophy (X-ALD) initially presenting as Addison's disease were collected from the Department of Endocrinology, First Medical Center of Chinese PLA General Hospital...Clinical data of two patients with X-linked adrenoleukodystrophy (X-ALD) initially presenting as Addison's disease were collected from the Department of Endocrinology, First Medical Center of Chinese PLA General Hospital. Relevant medical history, clinical features, laboratory tests, and genetic results were analyzed. The two male patients, aged 7 years (case 1) and 15 years (case 2), initially presented with generalized skin hyperpigmentation, without any family history of similar disorders. Both had normal growth and development, and adrenal CT and brain MRI revealed no significant abnormalities. Elevated very long-chain fatty acid (VLCFA) levels were detected. Genetic analyses identified a maternally inherited missense mutation (c.830G>A, p.Gly277Glu) in the ATP-binding cassette subfamily D member 1 (ABCD1) gene in case 1, and a missense mutation (c.1499G>T, p.Gly500Val) in case 2. Protein structural predictions indicated both mutations as potentially damaging or damaging, and both were classified as likely pathogenic according to American College of Medical Genetics and Genomics (ACMG) criteria (PM1/PM2/PP3_Moderate and PM2/PP3_Moderate/PM6, respectively), supporting their correlation with the clinical phenotype. Clinicians should maintain vigilance for X-ALD in male patients presenting with Addison's disease, and combined VLCFA and genetic testing can effectively prevent misdiagnosis or delayed diagnosis.
Zhonghua Nei Ke Za Zhi
· 2025 Sep · PMID 40904294
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To analyze the clinical characteristics of 14 patients with severe autoimmune glial fibrillary acidic protein astrocytopathy (GFAP-A). A retrospective analysis was conducted on the clinical data of 14 patients diagnosed...To analyze the clinical characteristics of 14 patients with severe autoimmune glial fibrillary acidic protein astrocytopathy (GFAP-A). A retrospective analysis was conducted on the clinical data of 14 patients diagnosed with severe GFAP-A in Xuanwu Hospital, Capital Medical University, between July 2023 and September 2024. (1) Fourteen patients were included in the study, including 11 males and 3 females, aged 15-66 years (average: 39±13 years). The time from disease onset to consciousness impairment was 4-15 days, with an average of 10±3 days. (2) The primary initial main symptoms were fever, headache, limb weakness, and abnormal mental behavior. As the condition worsened, all patients developed consciousness disorders, and 11 experienced respiratory failure requiring tracheal intubation. (3) Intracranial lesions often involved both cerebral hemispheres, the thalamus, basal ganglia, and the brainstem. Spinal cord lesions involved the cervical and thoracic regions. (4) Most patients had elevated intracranial pressure. In the cerebral spinal fluid (CSF), all patients exhibited elevated protein levels and a high white blood cell count, predominantly monocytes, along with reduced glucose levels. (5) Treatment encompassed combinations of immunotherapies, including hormones, human immunoglobulin, plasma exchange, or immunoadsorption. The clinical manifestations of critically ill GFAP-A patients are heterogeneous. Disease progression is rapid, and the symptoms are increasingly severe, making early diagnosis difficult. Head and spinal cord MRI, CSF analysis, and GFAP-IgG testing are essential for diagnosis. After immunotherapy, most patients have a good prognosis.
Li YF, Yang F, Wang HF
… +5 more, Chen ZH, Ling L, Cheng HM, Huang XS, Li M
Zhonghua Nei Ke Za Zhi
· 2025 Sep · PMID 40904293
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To investigate multi-system involvement in Kennedy's disease and its association with disease progression. We retrospectively reviewed the clinical, laboratory, and electrophysiological data from 48 genetically confirme...To investigate multi-system involvement in Kennedy's disease and its association with disease progression. We retrospectively reviewed the clinical, laboratory, and electrophysiological data from 48 genetically confirmed patients with Kennedy's disease at the Department of Neurology, First Medical Center of the Chinese PLA General Hospital, between February 2016 and February 2024. The disease progression rate was calculated based on the functional scores at baseline and follow-up. Correlation analyses and multiple linear regression models were employed to assess the relationships among clinical variables and to identify potential predictors of disease progression. The age of muscle weakness onset ranged from 16 to 66 years (mean 42±11 years), with a diagnostic delay of 5.0 (3.0, 9.8) years. Lower limb weakness was the most common initial symptom in 72.9% (35/48) of patients, and 37.5% (18/48) exhibited non-motor manifestations prior to the onset of weakness. Core motor manifestations included bulbar weakness (89.6%, 43/48) and symmetric proximal limb weakness (83.3%, 40/48), frequently accompanied by gynecomastia (74.2%, 23/31) and sexual dysfunction (64.6%, 31/48). The median CAG repeat length was 43 (42, 46), which showed a significant negative correlation with the age at onset (0.406, 0.004). Patients with CAG repeats > 43 had a higher prevalence of sexual dysfunction. Elevated serum muscle enzymes were observed in 97.9% (47/48), and abnormal sex hormone levels were detected in 81.2% (39/48). Sensory neuropathy was present in 68.1% (32/47), with CAG repeat length inversely correlating with compound muscle action potential (CMAP) amplitudes in the median (-0.29; -2.27, 0.029) and ulnar (-0.22; -2.23, 0.031) nerves. Low-frequency repetitive nerve stimulation (RNS) revealed a decrement in 43.3% (13/30) of patients, most commonly affecting the axillary and spinal accessory nerves. The disease progression rate was 1.3±0.3 (range: 0.5-2.0). Furthermore, serum creatine kinase-MB (CK-MB) levels were negatively correlated with disease progression rate (-0.303, 0.036). Kennedy's disease presents with diverse initial manifestations and frequent multi-system involvement. Non-motor manifestations may precede muscle weakness, serving as valuable clues for early diagnosis. Widespread sex hormone abnormalities (particularly testosterone/luteinizing hormone dysregulation) support the role of androgen insensitivity in disease pathogenesis. Sensory neuropathies are frequent and not length-dependent. The presence of decremental responses on low-frequency RNS suggests neuromuscular junction dysfunction, which may underlie motor impairment in patients with Kennedy's disease. Finally, serum CK-MB may serve as a potential biomarker for disease progression.
Deng Y, Ba YC, Wang QQ
… +7 more, Hong XY, Tan ZY, Huang Q, Wang Q, Zhang L, Yuan XY, Liao X
Zhonghua Nei Ke Za Zhi
· 2025 Sep · PMID 40904292
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To investigate the changes in and correlations between melanin-concentrating hormone (MCH) and androgen levels in the serum of patients with polycystic ovary syndrome (PCOS), aiming to provide a novel research perspectiv...To investigate the changes in and correlations between melanin-concentrating hormone (MCH) and androgen levels in the serum of patients with polycystic ovary syndrome (PCOS), aiming to provide a novel research perspective for its diagnosis. A cross-sectional study. A total of 307 subjects were enrolled from the physical examination center and endocrinology clinic of the Affiliated Hospital of Zunyi Medical University from June 2023 to June 2024. The cohort comprised 114 healthy controls and 193 patients with PCOS, diagnosed according to the Rotterdam criteria. The patients were grouped into four phenotypes: Phenotype A (hyperandrogenemia [HA]+ovulatory dysfunction [OA]+polycystic ovarian morphology [PCOM], =44), Phenotype B (HA+OA, =50), Phenotype C (HA+PCOM, =46), and Phenotype D (OA+PCOM, =53). Clinical data were collected for all subjects. Serum MCH levels were determined by enzyme-linked immunosorbent assay. The relationship between MCH and androgen-related risk factors for PCOS was analyzed using Spearman partial correlation analysis and stepwise multiple linear hierarchical regression. Binary logistic regression was used to analyze factors influencing PCOS onset. The diagnostic value of MCH for PCOS was evaluated using a receiver operating characteristic (ROC) curve. There were no significant differences in age and height between the healthy control group and the PCOS phenotypic groups (both >0.05). MCH levels [17.63 (12.69, 22.00), 17.31 (11.05, 20.09), 17.82 (11.47, 19.40), 16.50 (11.14, 19.41) μg/L vs. 12.14 (9.78, 15.05) μg/L], homeostatic model assessment of insulin resistance, fasting plasma glucose, fasting serum lisulin, body mass index, and weight were significantly higher across all four PCOS phenotypes (A, B, C, and D) than in healthy controls (all <0.05), whereas sex hormone-binding globulin (SHBG) contents were significantly lower (<0.05). Free androgen index (FAI), total testosterone (TES) and dehydroepiandrosterone (DHEA) levels were significantly higher in PCOS phenotypes A, B, and C than in the control group and PCOS phenotype D (all <0.05). Spearman partial correlation analysis revealed no significant correlation between MCH and TES, DHEA, or FAI in healthy controls and patients with non-HA PCOS (all >0.05). However, in PCOS patients with HA, MCH showed a significant positive correlation with TES and DHEA (=0.227 and 0.196, respectively; both <0.05), but not FAI (>0.05). Stepwise multiple linear hierarchical regression analysis showed that MCH was positively correlated with TES, DHEA and luteinizing hormone and negatively correlated with SHBG (all <0.05). Binary logistic regression indicated that an increase in MCH may be a potential risk factor for PCOS occurrence (1.113, 95% 1.012-1.224, 0.028). ROC analysis showed that MCH has diagnostic value for PCOS (<0.05), with an area under the curve of 0.713. Serum MCH is closely related to FAI, TES, and DHEA levels in PCOS patients and may play an important role in the etiology and progression of the syndrome.
Zhonghua Nei Ke Za Zhi
· 2025 Sep · PMID 40904291
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Publisher ↗
To analyze the clinical characteristics of immune checkpoint inhibitor (ICI)-induced type 1 diabetes (T1D). This was a retrospective case series study of clinical data from 24 patients with ICI-T1D admitted to People's...To analyze the clinical characteristics of immune checkpoint inhibitor (ICI)-induced type 1 diabetes (T1D). This was a retrospective case series study of clinical data from 24 patients with ICI-T1D admitted to People's Hospital of Henan Provincial between January 2018 and December 2024. The data collected included demographic characteristics, ICI usage, clinical manifestations, laboratory test results, and clinical outcome. Patients were categorized into mild and severe groups based on disease severity. Clinical characteristics between the two groups were compared using the Mann-Whitney test. Of the 24 patients, 21 (87.5%) were male and 3 (12.5%) were female, with an average age of (62.0±10.6) years. Patients in the severe disease group were significantly older than those in the mild disease group [(68.0±9.5) years vs. (58.4±9.8) years, <0.05]. Compared to patients with mild disease, those with severe disease had significantly higher rates of impaired consciousness (9/9 vs.2/15), shorter ICI treatment cycles [3 (2, 6) vs. 6 (5, 8)], shorter time from ICI initiation to diabetes diagnosis [68 (31, 168) d vs. 162 (135, 235) d], and shorter time from the onset of diabetes symptoms to medical consultation [4 (2, 5) d vs. 8 (4, 26) d] (all <0.05). The severe disease group also showed significantly higher blood glucose levels [43.0 (39.1, 57.3) mmol/L vs. 24.6 (19.6, 29.6) mmol/L] and a lower glycated hemoglobin level [6.8% (6.3%, 7.6%) vs. 7.9% (7.6%, 8.6%)], along with a higher incidence of fulminant T1D (8/9 vs. 2/15, all <0.05). All patients received insulin injection therapy. After discharge, fasting C-peptide levels in 3 patients with mild disease showed a transient increase to 0.26, 0.43, 0.49 nmol/L but declined again after six months. ICI-T1D is characterized by acute onset and rapid progression. Older patients are more likely to develop severe disease. All patients require insulin therapy.